Skip to main content
Log in

Effect of a Cognitive-Behavioral Stress Management Intervention on Salivary IgA, Self-Reported Levels of Stress, and Physical Health Complaints in an Undergraduate Population

  • Published:
International Journal of Rehabilitation and Health

Abstract

Research has indicated that the experience of stress reliably correlates with changes in immunological functioning. Further, interventions designed to reduce the experience of stress correlate with modest enhancement of immune function. The effects of such interventions vary widely, depending on the specific immune system variables measured and characteristics of the participants, including age and health status. To determine the effects of a cognitive-behavioral stress management intervention on salivary immunoglobulin A (sIgA), we randomly assigned 57 university undergraduates to a treatment or control condition. Treatment group participants met in groups of nine or ten students and received information about the stress response and immunity, training in diaphragmatic breathing and autogenic relaxation, and exposure to cognitive restructuring and assertiveness training. We assessed saliva samples, ratings of physical symptoms commonly associated with stress, and self-report of health complaints before and after the 5-week intervention period. Fifty-three participants completed the study. Reductions in stress levels from pre- to postintervention for both treatment and control participants were evident by increases in sIgA secretion rates and salivary flow and decreases in scores on the Undergraduate Stress Questionnaire, the Cohen–Hoberman Inventory of Physical Symptoms, and the Daily Stress Inventory. Treatment participants exhibited further reductions in stress, compared to control participants, as evidenced by lower scores on a subset of the self-report inventories. No treatment effects on sIgA were present. These results suggest that a stress management intervention such as the one used in this study can be beneficial in reducing levels of stress but may not be immunoenhancing.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

REFERENCES

  • Albright, G. L., Andreassi, J. L., and Brockwell, A. L. (1991). Effects of stress management on blood pressure and other cardiovascular variables. Int. J. Psychophysiol. 11: 213–217.

    Google Scholar 

  • Antoni, M. H., Baggett, L., Ironson, G., LaPerriere, A., August, S., Klimas, N., Schneiderman, N., and Fletcher, M. A. (1991). Cognitive-behavioral stress management intervention buffers distress responses and immunological changes following notification of HIV-1 seropositivity. J. Consult. Clin. Psychol. 59: 906–915.

    Google Scholar 

  • Auerbach, S. M., and Gramling, S. E. (1998). Stress Management: Psychological Foundations, Prentice-Hall, Upper Saddle River, NJ.

    Google Scholar 

  • Baker, G. H. (1991). Psychological factors and immunity: A selective review of recent advances. Psychiatria Fenn. 22: 47–52.

    Google Scholar 

  • Baker, R. C., and Kirschenbaum, D. S. (1993). Self-monitoring may be necessary for successful weight control. Behav. Ther. 24: 377–394.

    Google Scholar 

  • Benson, H. (1975). The Relaxation Response, William Morrow, New York.

    Google Scholar 

  • Berger, J. A., and O'Brien, W. H. (1997). The effects of cognitive-behavioral stress management interventions on immune function: A meta-analytic review. Manuscript in preparation. Bowling Green State University, Bowling Green, OH.

    Google Scholar 

  • Black, P. H. (1994). Central nervous system-immune system interactions: Psychoneuroendocrinology of stress and its immune consequences. Antimicrob. Agents Chemother. 38: 1–6.

    Google Scholar 

  • Brantley, P. J., Dietz, L. S., McKnight, G. T., and Jones, G. N. (1988). Convergence between the Daily Stress Inventory and endocrine measures of stress. J. Consult. Clin. Psychol. 56: 549–551.

    Google Scholar 

  • Brantley, P. J., Waggoner, C. D., Jones, G. N., and Rappaport, N. B. (1987). A Daily Stress Inventory: Development, reliability, and validity. J. Behav. Med. 10: 61–74.

    Google Scholar 

  • Cohen, S., and Hoberman, H. M. (1983). Positive events and social supports as buffers of life change stress. J. Appl. Soc. Psychol. 13: 99–125.

    Google Scholar 

  • Cohen, S., and Williamson, G. M. (1993). Stress and infectious disease in humans. Psychol. Bull. 109: 5–24.

    Google Scholar 

  • Crandall, C. S., Preisler, J. J., and Aussprung, J. (1992). Measuring life event stress in the lives of college students: The Undergraduate Stress Questionnaire (USQ). J. Behav. Med. 15: 627–662.

    Google Scholar 

  • Crist, D. M., Mackinnon, L. T., Thompson, R. F., Atterbom, H. A., and Egan, P. A. (1989). Physical exercise increases natural cellular-mediated tumor cytotoxicity in elderly women. Gerontology 35: 66–71.

    Google Scholar 

  • Elsesser, K., van Berkel, M., Sartory, G., Biermann-Goecke, W., and Oehl, S. (1994). The effects of anxiety management training on psychological variables and immune parameters in cancer patients: A pilot study. Behav. Cognit. Psychother. 22: 13–23.

    Google Scholar 

  • Evans, P., Bristow, M., Hucklebridge, F., Clow, A., and Pang, F. (1994). Stress, arousal, cortisol, and secretory immunoglobulin A in students undergoing assessment. Br. J. Clin. Psychol. 33: 575–576.

    Google Scholar 

  • Fillit, H. (1994). The clinical immunology of aging. Rev. Clin. Gerontol. 4: 187–197.

    Google Scholar 

  • Fuxe, K., Andersson, K., Eneroth, P., and Haerfstrand, A. (1989). Neurendocrine actions of nicotine and of exposure to nicotine smoke: Medical implications. Psychoneuroendocrinology 14: 19–41.

    Google Scholar 

  • Giberson, P. K., and Weinberg, J. (1992). Fetal alcohol syndrome and function of the immune system. Alcohol Health Res. World 16(1): 29–38.

    Google Scholar 

  • Green, M. L., Green, R. G., and Santoro, W. (1988). Daily relaxation modifies serum and salivary immunoglobulins and psychophysiologic symptom severity. Biofeed. Self-Regul. 13: 187–199.

    Google Scholar 

  • Green, R. G., and Green, M. L. (1987). Relaxation increases salivary immunoglobulin A. Psychol. Rep. 61: 623–629.

    Google Scholar 

  • Gruber, B. L., Hersh, S. P., Hall, N. R. S., Waltezky, L. R., Kunz, J. F., Carpenter, J. K., Kverno, K. S., and Weiss, S. M. (1993). Immunological responses of breast cancer patients to behavioral interventions. Biofeed. Self-Regul. 18: 1–22.

    Google Scholar 

  • Herbert, T. B., and Cohen, S. (1993). Stress and immunity in humans: A meta-analytic review. Psychosom. Med. 55: 364–379.

    Google Scholar 

  • Jasnoski, M. L., and Kugler, J. (1987). Relaxation, imagery, and neuroimmunomodulation. Ann. N.Y. Acad. Sci. 496: 722–730.

    Google Scholar 

  • Kanner, A. D., Coyne, J. C., Schaefer, C., and Lazarus, R. S. (1981). Comparison of two modes of stress measurement: Daily hassles and uplifts versus major life events. J. Behav. Med. 4: 1–39.

    Google Scholar 

  • Kennedy, S., Glaser, R., and Kiecolt-Glaser, J. (1990). Psychoneuroimmunology. In Cacioppo, J. T., and Tassinary, L. G. (eds.), Principles of Psychophysiology: Physical, Social, and Inferential Elements, Cambridge University Press, New York.

    Google Scholar 

  • Kiecolt-Glaser, J. K., and Glaser, R. (1988). Methodological issues in behavioral immunology research with humans. Brain Behav. Immun. 2: 67–78.

    Google Scholar 

  • Kiecolt-Glaser, J. K., Glaser, R., Strain, E., Stout, J., Tarr, K., Holliday, J., and Speicher, C. (1986). Modulation of cellular immunity in medical students. J. Behav. Med. 9: 5–21.

    Google Scholar 

  • Kirk, R. E. (1982). Experimental Design: Procedures for the Behavioral Sciences, 2nd ed., Brooks/Cole, Monterey, CA.

    Google Scholar 

  • Maier, S. F., Watkins, L. R., and Fleshner, M. (1994). Psychoneuroimmunology: The interface between behavior, brain, and immunity. Am. Psychol. 49: 1004–1017.

    Google Scholar 

  • Mayer, J. D., and Gaschke, Y. N. (1988). The experience and meta-experience of mood. J. Person. Soc. Psychol. 55: 102–111.

    Google Scholar 

  • McDowell, S. L., Weir, J. P., Eckerson, J. M., Wagner, L. L., Housh, T. J., and Johnson, G. O. (1993). A preliminary investigation of the effect of weight training on salivary immunoglobulin A. Res. Q. Exercise Sport 64: 348–351.

    Google Scholar 

  • Mouton, C., Fillion, L., Tawadros, E., and Tesser, R. (1989). Salivary IgA is a weak stress marker. Behav. Med. 15: 179–185.

    Google Scholar 

  • Nehlsen-Cannarella, S. L., Nieman, D. C., Balk-Lamberton, A. J., Markoff, P. A., Chritton, D. B. W., Gusewitch, G., and Lee, J. W. (1991). The effects of moderate exercise training on immune response. Med. Sci. Sports Exercise 23: 64–70.

    Google Scholar 

  • O'Brien, W. H., Korchynsky, R., Fabrizio, J., McGrath, J., and Swank, A. (1999). Evaluating group process in a stress management intervention: Relationships between perceived process and cardiovascular reactivity to stress. Res. Soc. Work Pract. 9: 608–630.

    Google Scholar 

  • O'Leary, A. (1990). Stress, emotion, and human immune function. Psychol. Bull. 108: 363–382.

    Google Scholar 

  • Pennebaker, J. (1980). The Psychology of Physical Symptoms, Springer, New York.

    Google Scholar 

  • Peterson, A. L., and Azrin, N. H. (1992). An evaluation of behavioral treatments for tourette syndrome. Behav. Res. Ther. 30: 167–174.

    Google Scholar 

  • Rider, M. S., and Weldin, C. W. (1990). Imagery, improvisation, and immunity. Arts Psychother. 17: 211–216.

    Google Scholar 

  • Schwarz, S. P., and Blanchard, E. B. (1991). Evaluation of a psychological treatment for inflammatory bowel disease. Behav. Res. Ther. 29: 167–177.

    Google Scholar 

  • Smith, D. J., and Taubman, M. A. (1992). Ontogeny of immunity to oral microbiota in humans. Crit. Rev. Oral Biol. Med. 3(1–2): 109–133.

    Google Scholar 

  • Virella, G. (1998). Introduction to Medical Immunology, 4th ed., Marcel Dekker, New York.

    Google Scholar 

  • Woolfolk, R. L., Lehrer, P. M., McCann, B. S., and Rooney, A. J. (1982). Effects of progressive relaxation and meditation on cognitive and somatic manifestations of daily stress. Behav. Res. Ther. 20: 461–467.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Berger, J.A., O'Brien, W.H. Effect of a Cognitive-Behavioral Stress Management Intervention on Salivary IgA, Self-Reported Levels of Stress, and Physical Health Complaints in an Undergraduate Population. International Journal of Rehabilitation and Health 4, 129–152 (1998). https://doi.org/10.1023/A:1022900812666

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1022900812666

Navigation